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Current Status on ICD 10 Implementation

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What is the status on ICD-10? In this Infographic I bring you the facts you always wanted to know & 6 foundation blocks for successful ICD-10 implementation – PowerPoint PPT presentation

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Title: Current Status on ICD 10 Implementation


1
Current Status on ICD-10 Implementation
Presented By Victoria, thepracticebridge
2
  • We will be using ICD-10 another 19 days. Before
    that I will make you to walk through the status
    on ICD-10 implementation.

3
I have few questions in my mind
  • Does the claims errors will Increase?
  • Will A/R could rise?
  • Will there be a rise in claim denial rates?

4
  • 2015 survey was intended only for healthcare
    providers. 60 responded on behalf of a hospital
    or health system. Hope we will get more
    clarifications if we go through the survey.

5
  • According to the survey, just 7 of physicians
    said they have started transitioning to ICD-10
    extensively.
  • 31 of respondents said they had not started the
    transition at all.
  • Among solo physicians, 82 said they have not
    started the transition at all or have made only
    limited
  • 42 of respondents said they are "not at all
    confident" that the implementation of ICD-10 will
    cause no serious disruptions.
  • 83 of respondents expect the transition to
    result in delayed or denied claims
  • 36 expect to face disruptions that require them
    to draw from personal funds

6
  • 32 said they might reduce staff size, work hours
    or benefits and
  • 30 said they might retire early because of
    anticipated cash-flow issues related to the
    transition
  • 65 said they are capable of processing ICD-10
    codes
  • 52 said their practice management software was
    capable of processing ICD-10 codes
  • 1 said they will need to completely replace
    their IT systems to comply with ICD-10.

7
A recent survey of 1,100 organizations found
  • More than half of respondents were uncertain of
    the actual ICD-10 deadline.
  • And more than half had not yet completed
    end-to-end testing.
  • Some providers still believe the switch to
    ICD-10 isn't going to happen this year.

8
  • "This is an off-election year, and if I was a
    politician, I would roll ICD-10 out during an
    off-election year rather than delay it," says Mr.
    Joshua Berman, Relay Health ICD-10 Director.

9
  • Provider organizations that haven't adequately
    prepared for the switch are going to have issues
    with the processes that ICD-10 requires. However
    even organizations that have prepared may still
    have problems.

10
This isn't a technology change, it's a
process change
  • The switch to ICD-10 requires coding staff,
    physicians and all others who document conditions
    to be properly trained to ensure billing is done
    correctly.

11
  • All providers are likely to encounter some issues
    with the switch to ICD-10, including an increase
    in claim denials and the amount of time it takes
    payers to process claims

12
  • For small practices Road to 10 from CMS has
    primer for clinical documentation, clinical
    scenarios, and other specialty-specific resources
    to help with implementation.

13
  • Medicare claims processing systems will not have
    the capability to accept ICD-9 codes for dates of
    services after September 30, 2015

14
6 foundations for ICD-10 implementation you
cant ignore!
  • ICD-10 CM/PCS Communication
  •  
  • Coding Education
  •  
  • Clinical Documentation Initiatives
  • IT Plan
  • Revenue Cycle Plan
  •  
  • Post "Go Live" Health Information Management
    coding activities

15
Communication
  • Concise Messaging
  • Vision Statement
  • Partners Roles
  • Timelines
  • Defined Methods of Communication

16
ICD-10 CMS/PCS Vision Statement
  • Clarity-steering the team in the right direction
  • Inspiring and meaningful versus compliance driven
  • Expected outcomes-how we will be working
    differently following ICD-10 implementation

17
Partners and Roles
  • Identify
  • Internal groups
  • External groups (Partners)
  • Agreed upon communications

18
  • Have a timeline that outlines milestones,
    secondary tasks and deadlines keep implementation
    teams on task.
  • Multiple communication methods should be used
    Thumb of rule says, seven times, seven ways

19
Coding Education
  • Self assessment goals checklists
  • Rate your self on a scale 1(Goal not accomplished
    at all) to 5(Goal accomplished)
  • Are you aware of your foundational knowledge
    strengths related to AP, disease processes,
    pharmacology, etc.?
  • Are you completing tasks to improve your
    weaknesses related to AP, disease processes,
    pharmacology, etc.?

20
  • Are you networking with a subject matter expert
    and peers?
  • Are you practicing and applying codes to real
    world documentation?
  • Are you working to understand the ICD-10-CM/PCS
    coding guidelines?
  • Are you gaining a deeper understanding of the
    clinical documentation improvement protocols?
  • Do you work collaboratively with clinical
    documentation specialists when a clarification or
    query is needed?

21
Clinical Documentation Improvement
  • The success for this includes
  • physician involvement
  • communicating documentation gaps
  • Other key data findings
  • Which agree upon goals of a CDI improvement
    process and ongoing focused reviews with
    feedback.

22
  • Medical staff, CDI staff the coding staff will
    need education on the findings from documentation
    reviews
  • Findings should include discussion of the
    documentation elements needed to support ICD-10
    codes through use of specific examples.
  • The value of more concise data capture for high
    quality data should be emphasized.

23
IT Block
  • For the most part, IT plans for the transition to
    ICD-10 are well underway, due in part to the
    conversion to 5010 compliance.
  • Important elements of the IT building block for
    ICD-10 readiness to be monitored throughout the
    implementation include.

24
  • Communications to and from vendors
  • Testing of system capabilities
  • The costs associated with IT implementations
  • Necessary upgrades and system maintenance.
  • Decisions around how ICD-9 and ICD-10 databases
    will be accessed and maintained will need to be
    made.

25
Revenue Cycle Block
  • The 9 pieces of advice from Government Health IT
    practices must consider
  • Practices should develop a budget and strategy to
    provide for additional cash reserves should
    delays in payment occur.
  • Practices should conduct financial modeling to
    understand the impacts of moving from ICD 9 to
    ICD 10 the impacts should be looked at by
    provider, by facility, by service line, and by
    geography if applicable.

26
  • The potential for backlogs in medical Coding,
    billing, and claim edits should be analyzed and a
    strategy developed to work the backlogs.
  • A strategy for pre and post ICD 10 denials
    management should be developed.
  • Assess the readiness of external vendors who
    support coding, billing, follow up and denials.
  • Any audits currently performed (compliance, RAC,
    etc.) should be reviewed to determine ICD 10
    impact.

27
  • Managed care contracts should be reviewed and if
    necessary, renegotiated to decrease negative
    impacts to the bottom line.
  • The readiness of high volume payers should be
    assessed to determine their ability to process
    claims. Many payers are now posting readiness
    information on their web sites.
  • Conduct CDI reviews using ICD 10 code sets to
    determine if documentation contains the
    specificity necessary for ICD 10.

28
Post Go Live HIM/Coding Activities.
  • Most important block for ICD-10 implementation is
    to plan the activities to undertake following the
    deadline. As Sir Walter Scott said, I can give
    you a six-word formula for success Think things
    through then follow through

29
  • Practices must follow through and monitor coding
    accuracy and productivity following go live.
  • When problems are identified, strategies should
    be implemented to address workflow problems,
    process problems, and resource issues.
  • Determine if further education and training is
    needed and provide it expeditiously to prevent
    future issues.

30
  • Monitor for opportunities to improve data
    integrity through EHR enhancements, monitoring of
    alerts, and communication with physicians
    clinical documentation improvement staff.
  • Finally, monitor productivity to manage
    responding to staffing needs.
  • Go live will be a challenging time for all and
    retention of highly trained, skilled coding staff
    will be essential.

31
  • Which of these building blocks needs more
    attention in your organization? Which has been
    successful?

32
Share Your Views With Us atwww.thepracticebridge
.comand if you like it, kindly subscribe to our
blog updates!
33
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